RENSHAW REIMBURSEMENT & CONSULTING
CLINICAL EXCELLENCE.
REVENUE INTEGRITY.
Our Partners
Why choose us
Clinical & Reimbursement Expertise
Our Methodology
Your facility is our priority. We help nursing facilities turn operational goals into measurable reimbursement results. With extensive experience in PDPM, MDS accuracy, and regulatory compliance, our team works to ensure your facility receives appropriate payment for the care you deliver.
From strategic PDPM guidance to hands on operati
Your facility is our priority. We help nursing facilities turn operational goals into measurable reimbursement results. With extensive experience in PDPM, MDS accuracy, and regulatory compliance, our team works to ensure your facility receives appropriate payment for the care you deliver.
From strategic PDPM guidance to hands on operational support we assist facilities at every level. We identify potential MDS issues before admission, review documentation for accuracy, and help ensure the clinical record fully supports the services provided while reducing the risk of CMS penalties and missed reimbursement. Our focus is simple: strengthen reimbursement integrity, support regulatory compliance, and position your facility for long term success that includes an improved and stronger FIVE-STAR outcome.
Our Methodology
Clinical & Reimbursement Expertise
Our Methodology
Whether you need quick assistance with MDS completion or a comprehensive QA review, we provide the expertise to support your facility's success. Our mission is to build strong partnerships while helping facilities optimize reimbursement and maintain regulatory confidence. Unlike automated scrubber programs that can only analyze what alrea
Whether you need quick assistance with MDS completion or a comprehensive QA review, we provide the expertise to support your facility's success. Our mission is to build strong partnerships while helping facilities optimize reimbursement and maintain regulatory confidence. Unlike automated scrubber programs that can only analyze what already exists in this submitted medical record, we go further. We work directly with your team to identify opportunities, strengthen documentation, and address potential issues before they impact reimbursement or compliance. We provide long term care consulting and professional MD's support to help ensure your facility is accurately reimbursed for the care you deliver.
Clinical & Reimbursement Expertise
Clinical & Reimbursement Expertise
Clinical & Reimbursement Expertise
We are registered nurses and RAC-CT and RAC-CTA professionals with extensive experience in long term care reimbursement, quality assurance, and MD's operations. With more than 50 years of combined experience, we bring practical knowledge and proven strategies to help facilities operate successfully and capture accurate reimbursement. Our
We are registered nurses and RAC-CT and RAC-CTA professionals with extensive experience in long term care reimbursement, quality assurance, and MD's operations. With more than 50 years of combined experience, we bring practical knowledge and proven strategies to help facilities operate successfully and capture accurate reimbursement. Our work focuses on strengthening communication, improving documentation and ensuring the clinical record supports the care being delivered. These efforts help facilities improve their financial performance while maintaining regulatory confidence. We support facilities with Medicaid Case Mix index (CMI), quality reporting programs (QRP), 802 compliance, and other key reimbursement and regulatory areas. Our goal is simple: help ensure your facility receives appropriate reimbursement while maintaining strong operational performance.
Our strategy
QM & Casper Oversight
Accurate ICD Coding Matters
QM & Casper Oversight
Is your MD's Professional reviewing and sharing your Casper reports with you each month? Do you know how many quality measures are currently flagging for your facility? Are you confident your QRP reporting is compliant? Our team helps facilities identify and correct quality measure issues before they escalate. We work to reduce QM flags a
Is your MD's Professional reviewing and sharing your Casper reports with you each month? Do you know how many quality measures are currently flagging for your facility? Are you confident your QRP reporting is compliant? Our team helps facilities identify and correct quality measure issues before they escalate. We work to reduce QM flags and ensure facilities meet QRP requirements while preventing costly APU reductions.
What Are NTA Points?
Accurate ICD Coding Matters
QM & Casper Oversight
Under PDPM, the nontherapy ancillary component (NTA) uses a weighted comorbidity scoring system. High-cost conditions and certain extensive services generate NTA points to contribute to a residents NTA case mix classification. A resident's total NTA score is calculated by adding the points associated with each qualifying comorbidity or s
Under PDPM, the nontherapy ancillary component (NTA) uses a weighted comorbidity scoring system. High-cost conditions and certain extensive services generate NTA points to contribute to a residents NTA case mix classification. A resident's total NTA score is calculated by adding the points associated with each qualifying comorbidity or service documented in the medical record. The higher the NTA score, the higher the NTA reimbursement component under PDPM. Accurate identification and documentation of these conditions is essential to ensure appropriate reimbursement. Our team helps facilities recognize qualifying conditions and ensure documentation supports the full NTA score.
Accurate ICD Coding Matters
Accurate ICD Coding Matters
Accurate ICD Coding Matters
Failure to capture and code accurate diagnoses will result in under-reimbursement. Under PDPM, the primary diagnosis determines the resident's clinical category and directly impacts reimbursement. Accurate coding often requires careful review of the medical record and, when appropriate, physician queries to clarify diagnoses and ensure
Failure to capture and code accurate diagnoses will result in under-reimbursement. Under PDPM, the primary diagnosis determines the resident's clinical category and directly impacts reimbursement. Accurate coding often requires careful review of the medical record and, when appropriate, physician queries to clarify diagnoses and ensure the clinical picture is fully captured. Return to provider primary diagnosis codes may result in no clinical category assignment and little or no reimbursement. Identifying and correcting these issues before submission helps ensure facilities receive appropriate payment for the care they are providing. Our team helps facilities review diagnosis, strengthen documentation, and ensure ICD 10 coding accurately reflects the resident's conditions.
.png/:/cr=t:16.82%25,l:0%25,w:100%25,h:66.36%25/rs=w:600,h:273,cg:true)